中国实用内科杂志

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糖皮质激素治疗肾脏疾病临床经验

蔡广研   

  1. 作者单位:解放军总医院肾脏病科 全军肾脏病研究所,北京 100853
  • 出版日期:2013-10-01 发布日期:2013-10-10
  • 作者简介:蔡广研,主任医师、教授、博士生导师。解放军总医院肾脏病科副主任、全军肾脏病研究所副所长。兼任中华医学会肾脏病学分会副主任委员、解放军肾脏病学专业委员会副主任委员、中国肾脏内科医师协会常务委员、卫生部临床路径技术审核专家;担任《中华肾脏病杂志》副主编、《中国实用内科杂志》常务编委及《中华医学杂志英文版》等期刊编委或通讯编委。荣获“求是”杰出青年奖、中国青年科技奖、军队创新人才工程“学科拔尖人才培养对象”、总后科技新星与北京市科技新星等荣誉。

Use of glucocorticoids in the treatment of kidney diseases.

CAI Guang-yan.   

  1. Department of Nephrology,Kidney Institute of Chinese PLA,State Key Laboratory of Kidney Diseases,Chinese PLA General Hospital,Beijing 100853,China
  • Online:2013-10-01 Published:2013-10-10

摘要:

多数肾脏疾病的发生、发展与免疫异常及炎症反应有关,糖皮质激素具有强大的抗炎和免疫抑制作用,是治疗肾病综合征、进展期肾病或病理有活动性病变的免疫介导性肾脏疾病的主要药物。但肾脏病应用激素治疗一般起始剂量大、疗程较长,使用不当会造成严重的不良反应。因此,应参照国内外关于肾脏病治疗的最新指南规范使用,严格掌握其适应证、疗效判断标准及影响因素,熟悉激素引起的副反应,坚持个体化治疗,避免盲目追求某些实验室指标(如蛋白尿)的减少而过度使用,在取得肾脏病临床缓解的同时尽可能减少不良反应。

关键词: 糖皮质激素, 肾脏疾病

Abstract:

Abstract:The initiation and progression of many renal diseases are associated with abnormal immune and inflammatory reactions.Glucocorticoids have powerful anti-inflammatory and immunosuppressive effects,which plays an important role in the treatment of immune-mediated kidney diseases,including nephrotic syndrome,progressive glomerulonephritis or disorders with active pathological lesions.Treatment of kidney diseases with glucocorticoids generally starts at high doses and maintain for a long course.Improper use can cause serious adverse reactions.Therefore,renal physicians should prescribe medication based on the latest clinical guidelines to perform standard use with definite indications.Doctors should be familiar with treatment efficacy,its affecting factors,and hormone-induced side effects.Individualized treatment is advocated to avoid the excessive use of glucocorticoids.Clinical remission of renal diseases should be achieved with less adverse reactions during treatment with glucocorticoids.

Key words: glucocorticoids, kidney diseases

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